研究全程新辅助治疗（TNT）联合全直肠系膜切除（TME）对局部进展期直肠癌（LARC）预后的影响。

选取50例2019年1月至2020年12月接受治疗的LARC患者为研究对象，按照数字表法将患者随机分为TNT组（TNT联合TME，n=25例）和传统组（传统新辅助治疗联合TME，n=25例）。采用SPSS 22.0统计软件分析数据，计量资料用（）表示，采用独立样本t检验；计数资料用[例（%）]表示，采用秩和检验或χ²检验；生存分析采用Kaplan-Meier法并行Log-Rank检验。P<0.05为差异有统计学意义。

两组患者临床完全缓解（cCR）率及不良反应情况比较，差异无统计学意义（P>0.05）；两组患者肿瘤消退分级（TRG）情况比较，差异有统计学意义（P<0.05），且TNT组pCR率显著高于传统组（P<0.05）；TNT组患者R0切除率显著高于传统组（P<0.05），两组患者围手术期的其他指标比较差异均未见统计学差异（P>0.05）；Kaplan-Meier分析显示，TNT组和传统组患者的累积总生存率比较未见统计学差异（P>0.05），TNT组患者的累积无病生存率显著高于传统组（P<0.05）。

TNT联合TME治疗LARC相较于传统新辅助治疗在不增加新辅助治疗不良反应、术后并发症及总生存率的前提下，近远期疗效显著，不仅可有效提高患者肿瘤的 pCR 率及 R0 切除率，还可提高患者的术后无病生存率，是一种安全、有效的治疗策略。

To investigate the effect of total neoadjuvant therapy (TNT) combined with total mesorectal excision (TME) on the prognosis of locally advanced rectal cancer (LARC).

Fifty patients with LARC who received treatment from January 2019 to December 2020 were selected as the study objects, and the patients were randomly divided into the TNT group (TNT combined with TME, n=25 cases) and the traditional group (traditional neoadjuvant therapy combined with TME, n=25 cases) according to the numerical table method. SPSS 22.0 statistical software was used to analyze the data. The measurement data were expressed as () and independent sample t test was used. The count data were represented by [cases (%)] using Rank Sum test or χ² test. Kaplan-Meier method and Log-Rank test were used for survival analysis. P<0.05 was considered statistically significant.

There was no significant difference in clinical complete response (cCR) rate and adverse reactions between the two groups (P>0.05). Tumor regression grade (TRG) was significantly different between the two groups (P<0.05), and the pCR rate of TNT group was significantly higher than that of traditional group (P<0.05). The R0 removal rate in TNT group was significantly higher than that in traditional group (P<0.05), and there were no significant differences in other perioperative indicators between the two groups (P>0.05). Kaplan-Meier analysis showed that there was no significant difference in the cumulative overall survival rate between the TNT group and the traditional group (P>0.05), and the cumulative disease-free survival rate in the TNT group was significantly higher than that in the traditional group (P<0.05).

Compared with traditional neoadjuvant therapy, TNT combined with TME in the treatment of LARC has significant short-term and long-term efficacy without increasing adverse reactions, postoperative complications and overall survival rate of neoadjuvant therapy. It can not only effectively improve the pCR rate and R0 resection rate of patients' tumors, but also improve the postoperative disease-free survival rate of patients. It is a safe and effective treatment strategy.